Duke proposes to create a Clinical Translational Science Institute (CTSI). This institute will accomplish four specific aims: 1) To create an institute that will transform how fundamental discoveries are translated into improved medical care by supporting creative translational research teams. The institute will provide leadership and resources for original translational and clinical research, and it will develop and perform studies regarding novel methods and approaches to translational and clinical science. 2) Create an environment in which trainees at all levels, including medical and nursing school students, physical therapists, pharmacologists, house staff, fellows, graduate students, junior faculty and career transition faculty can be trained in translational and clinical research. The training will be built on the principle that a rich clinical and translational research environment will provide Duke trainees with models and opportunities for success. 3) Integrate translational and clinical science by fostering collaboration among Duke's departments, institutes, centers, and schools using human resources supported by modern bioinformatics and a new clinical research unit designed to integrate intensive measurements of biological processes. 4) Develop a community model for understanding how to translate the findings of research from bench to bedside to populations using advanced informatics and health services delivery methods. The Duke CTSI will be founded on three entities, or pillars, including the Duke Translational Research Institute (DTRI), the Duke Clinical Research Institute (DCRI), and the Duke Center for Community Research (DCCR). These three entities will bring together and expand existing programs, and will be designed to emphasize the continuities along the spectrum of research that begins in a basic science laboratory and concludes with novel therapies that change outcomes for individual patients. These three pillars (DCRI, DTRI, and DCCR) will be administratively joined into the new Duke Clinical and Translational Science Institute (Duke CTSI), the core of this application. This new institute will link with other key programs, including the Duke Comprehensive Cancer Center, the Duke University School of Nursing, and the Duke Institute for Genome Sciences and Policy, to create a comprehensive home for clinical and translational researchers. The creation of the CTSI is patricianly relevant to public health as it will create an environment that will foster speedier delivery of new interventions and healthcare practices to the community.